Civil liberties

Against People should be able to go where they want, when they want, without others knowing where they are.  They have a right to roam.
For 40% of persons with dementia are kept behind locked doors at some point in their illness, so the right to roam is already restricted.  This system may actually increase, rather than restrict, people’s liberty. 

Assistive technology to identify patients’ location is already in use. For example, other systems, (eg Just Checking) allow caregivers to monitor the movements of patients inside their house and at the most severe level of vulnerability, pressure pads can alert staff in a care home that a patient has got out of bed.

Stigma

Against It puts the person with dementia into the same category as criminals, pets and even store merchandise. 
For Patients who need to ask for help because they are lost may feel frightened, embarrassed and stigmatised by their predicament.  This is reduced if they can be found before they feel the need to do this. 

Stigma arises not from the technology but from the way in which it is discussed.  For example, the term ‘tag’ is short and therefore suitable for headlines – but is stigmatising because it implies lack of consent.  A less stigmatising term is ‘tracking’.  The fact that the same technology can be used for coercion is unfortunate.  Someone who felt stigmatised by use of the device should not use it.

Depersonalisation

Against It depersonalises someone who is already vulnerable to this in many other ways. 
For Potentially the tracking system affords persons with dementia greater freedom and allows them to take part in more normal activities.

Mental Capacity

Against
People with dementia may be unable to say clearly that they do not want to be tracked or may be less able to resist caregivers who are anxious to reduce (for whatever reason) the risks associated with getting lost.

For
In our experience, the issue of getting lost is one which most patients can understand.  Most of the patients we have piloted the devices on have been able to weigh up the pros and cons.  For example, one said that it was ‘like a cow bell’, but still thought he would like the increased security. 

Our device is not fixed and so if a patient does not want to use it, they can remove it.  So, in that circumstance, the use of a device would not only be inappropriate but also, would not work. 
Where the patient is unable to make a realistic assessment of risk, the issue becomes ‘who should decide that the patient’s best interests are served by using the system?’.   In our view, the family is best placed to do this.  Where the patient has no family or informal caregiver, and is entirely looked after by public services, then the newly established Independent Mental Capacity Advocates service will be well placed to act for the patient.

Wrong target

Against
The devices are more about treating the caregiver’s anxiety than about risks to the patient.

For
In a survey of 100 caregivers of people with dementia, relieving their own anxiety was the main reason caregivers gave as to why they would use a tracking device. The burden of caring for someone with dementia is often great. Anxiety that someone may get lost can lead caregivers to lock patients in their home and can contribute to a decision to place the person with dementia in a care home. Often, reducing a caregiver’s anxiety will serve the interests of the patient and may increase their freedom.

A detrimental diversion

Against
Tracking technology will be adopted as a technological ‘quick’ fix for a complex problem. It may mean the problem is not carefully considered or is used to justify reduced staffing ratios.

For
This is a potential problem with all Assistive Technologies. It is important that structures are developed for assessing the benefits and risks of assistive technologies for an individual, so that risks can be minimised.

A waste of money

Against
If, in a particular individual case it does not help, it will be an expensive waste, which caregivers or the taxpayer can ill afford.

For
GPS devices are not 100% accurate and do not always work. Nevertheless, it is better to know where someone is some of the time and to realise that if you cannot locate them, it is probably because they are indoors, than to have no idea at all.

Our returns policy allows return of MyBeacons if it is rapidly apparent that they are unsuitable. 

The flexibility of our system means that public sector reproviders can use my beacon's in whatever way they deem most cost-effective. 

Too complicated

Against
Elderly caregivers cannot use this technology.

For
Caregivers must be able to charge the device, make sure the patient carries it and use a telephone if they become lost. This may be too complicated in a few cases. The 24/7 telephone service, which can be contacted by caregivers to check location, is run by an alarm call centre with daily experience of talking with elderly frail people. In addition, the system has the flexibility that a patient’s location can be found by relatives with PC or mobile-phone access to the internet.

Unethical use

Relatives or caregivers usually act in the patient’s best interests.  Nevertheless, the protection of the very vulnerable from unwise or malign use is important.  We will cooperate with any statutory agencies if evidence of this is brought to our attention.  Measures such as multidisciplinary meetings or Guardianship can be undertaken in such cases.